Sweet Dreams, Baby

From the WebMD Archives

March 7, 2000 (Minneapolis) -- In recent years, parents have become much more aware of the need to keep babies from sleeping face-down to reduce the risk of Sudden Infant Death Syndrome (SIDS). But members of a national task force say there is much more that parents and caregivers can do, including keeping those cuddly stuffed animals out of baby's bed.

Among their other recommendations in an article published in this month's issue of Pediatrics: Babies shouldn't be allowed to share beds; they shouldn't be put to sleep on adult beds, soft sofas, or in overheated rooms; and they should sleep on their backs whenever possible.

Although SIDS is a leading cause of infant death in the U.S., its causes remain a mystery. Since 1992, when the American Academy of Pediatrics (AAP) recommended that infants be placed on their backs or sides to sleep, the SIDS death rate has been cut nearly in half. But the task force of pediatric experts says it's not nearly enough.

"While the '92 recommendation suggested back or side, we now emphasize that back is best," task force member Michael Malloy, MD, tells WebMD. Malloy is professor in the department of pediatrics at the University of Texas in Galveston.

While allowing babies to sleep on their sides is not as safe as putting them on their backs, it is still much safer than letting them sleeping face-down, the article says.

Death from SIDS declined steadily from 1992 to 1996, but experts have seen a leveling-off in the decline. They note that 20% of infants still sleep face down, particularly those who are members of minority groups.

Another important recommendation is to put the infant into a crib -- not an adult bed -- that conforms to the standards of the Consumer Product Safety Commission. Also, infants should not be put on waterbeds, sofas, or other soft surfaces, the task force says.

Parents should also refrain from sleeping with their babies on beds or sofas, and should not allow babies to sleep with siblings. According to the product safety commission, "many cases of infant suffocation have been reported during bed sharing."


That cute teddy bear could be a hazard, the article's authors say. Soft materials, such as pillows, comforters, stuffed toys, and quilts, should be kept away from the infant's sleeping area. Blankets and sheets should be tucked in around the crib mattress and should not reach up farther than the baby's chest.

Overheating of the infant and the room should also be avoided, according to the task force. SIDS statistics have always shown higher rates of the syndrome during winter months. The bedroom temperature should be kept at a level comfortable for a lightly clothed adult, and infants should not be over-bundled.

But simply putting babies to sleep in the correct position can go a long way toward reducing SIDS, Malloy says. "Physicians can play an important role by passing that information on to parents when they see children for routine well-children visits," he says.

Experts do suggest a certain amount of time on their tummies while babies are awake and supervised, for developmental reasons and to help prevent flat spots on their heads, the study notes.

"It's always important to review current practices, and [a significant] impact has been made to the recommendation for positioning babies" with the task force's recommendations, says Richard J. Martin, MD, who reviewed the article for WebMD. "Community education and resources are key, particularly among day-care providers, clinics, and [minority] communities." Martin is director of the division of neonatology at Rainbow Babies' and Children's Hospital in Cleveland.

"For those parents who have already changed their infants' sleeping position to the back, they should know that they've clearly done the right thing," Martin says. "For those who haven't or who have ignored the message, they should pay attention to the suggestions from this latest report."

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